Background: In the absence of an adult vaccination register, coverage estimates for influenza and pneumococcal vaccination come from surveys and other data sources.

Methods: Systematic review and meta-analysis of studies examining vaccination coverage in Australian adults from 1990 to 2015, focusing on groups funded under the National Immunisation Program, and intervals prior to and following the introduction of universal funding.

Results: Twenty-two studies met the inclusion criteria; 18 used self-report to determine vaccination status. There were 130 unique estimates of coverage extracted. Among adults aged &ge;65y, during the period of universal funding (1999-onwards), the summary estimate of annual influenza vaccination coverage from 27 point estimates was 74.8&nbsp;% (95 % CI 73.4&ndash;76.2&nbsp;%; range 63.9&ndash;82.4&nbsp;%); prior to this period (1992&ndash;1998) from 10 point estimates it was 61.3&nbsp;% (95 % CI 58.0&ndash;64.6&nbsp;%; range 44.3&ndash;71.3&nbsp;%). For the period of universal funding for pneumococcal vaccination (2005-onwards) the summary estimate for coverage was 56.0&nbsp;% (95 % CI 53.2&ndash;58.8&nbsp;%; range 51.2&ndash;72.8&nbsp;%, 10 point estimates); prior to 2005 it was 35.4&nbsp;% (95 % CI 18.8&ndash;52.0&nbsp;%; range 15.4&ndash;45.2&nbsp;%). Coverage for both vaccines was significantly higher following the introduction of universal funding. Influenza vaccination coverage in those aged 18&ndash;65&nbsp;years with a medical indication was lower but data were not combined. Seven studies reported on Aboriginal Australians with three studies reporting&nbsp;five&nbsp;coverage estimates for influenza vaccination in adults &ge;65&nbsp;years (range 71 % - 89 %).

Conclusions: Adult influenza and pneumococcal vaccination coverage has increased since the introduction of universal funding, but remains sub-optimal, with pneumococcal coverage lower than influenza. Implications: This review highlights the need for more coverage data overall and in high risk groups, to support public health programs to improve coverage.

Fig1: Flow diagram of search strategy results- description. This figure shows the number of studies included and excluded at each stage of the review process

Mentions:
The initial search strategy retrieved a total of 219 titles and abstracts, of which 45 were duplicates. After screening the titles and abstracts, the full texts of 44 reports were retrieved of which 22 (including 15 peer-reviewed and seven non-peer reviewed reports) met the inclusion criteria for the review (see Fig. 1). Of those reports retrieved but not included, ten studies did not report vaccination coverage, four studies investigated an intervention and did not report coverage, four reported coverage only for a specific population sub-group, three reported only on vaccine efficacy or safety, and one paper reported on a subset of data from one of the reports included.Fig. 1

Fig1: Flow diagram of search strategy results- description. This figure shows the number of studies included and excluded at each stage of the review process

Mentions:
The initial search strategy retrieved a total of 219 titles and abstracts, of which 45 were duplicates. After screening the titles and abstracts, the full texts of 44 reports were retrieved of which 22 (including 15 peer-reviewed and seven non-peer reviewed reports) met the inclusion criteria for the review (see Fig. 1). Of those reports retrieved but not included, ten studies did not report vaccination coverage, four studies investigated an intervention and did not report coverage, four reported coverage only for a specific population sub-group, three reported only on vaccine efficacy or safety, and one paper reported on a subset of data from one of the reports included.Fig. 1

Background: In the absence of an adult vaccination register, coverage estimates for influenza and pneumococcal vaccination come from surveys and other data sources.

Methods: Systematic review and meta-analysis of studies examining vaccination coverage in Australian adults from 1990 to 2015, focusing on groups funded under the National Immunisation Program, and intervals prior to and following the introduction of universal funding.

Results: Twenty-two studies met the inclusion criteria; 18 used self-report to determine vaccination status. There were 130 unique estimates of coverage extracted. Among adults aged &ge;65y, during the period of universal funding (1999-onwards), the summary estimate of annual influenza vaccination coverage from 27 point estimates was 74.8&nbsp;% (95 % CI 73.4&ndash;76.2&nbsp;%; range 63.9&ndash;82.4&nbsp;%); prior to this period (1992&ndash;1998) from 10 point estimates it was 61.3&nbsp;% (95 % CI 58.0&ndash;64.6&nbsp;%; range 44.3&ndash;71.3&nbsp;%). For the period of universal funding for pneumococcal vaccination (2005-onwards) the summary estimate for coverage was 56.0&nbsp;% (95 % CI 53.2&ndash;58.8&nbsp;%; range 51.2&ndash;72.8&nbsp;%, 10 point estimates); prior to 2005 it was 35.4&nbsp;% (95 % CI 18.8&ndash;52.0&nbsp;%; range 15.4&ndash;45.2&nbsp;%). Coverage for both vaccines was significantly higher following the introduction of universal funding. Influenza vaccination coverage in those aged 18&ndash;65&nbsp;years with a medical indication was lower but data were not combined. Seven studies reported on Aboriginal Australians with three studies reporting&nbsp;five&nbsp;coverage estimates for influenza vaccination in adults &ge;65&nbsp;years (range 71 % - 89 %).

Conclusions: Adult influenza and pneumococcal vaccination coverage has increased since the introduction of universal funding, but remains sub-optimal, with pneumococcal coverage lower than influenza. Implications: This review highlights the need for more coverage data overall and in high risk groups, to support public health programs to improve coverage.